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11070100CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 2 INFINITE LOOP FLR 1 CONTRACTOR: XL CONSTRUCTION PERMIT NO: 11070100 OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED: 09/01/2011 OWNER'S PHONE: 4089961010 MILPITAS, CA 95035 PHONE NO: (408) 240-6000 LICENSED CONTRACTOR'S DECLARATION F F F BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lie.#� MECH RESIDENTIAL COMMERCIAL Contractor ?<_ (4)ISfi�'ate I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: APPLE: 1ST FLOOR DEMO OF NON -BEARING INTERIOR (commencing with Section 7000) of Division 3 of the Business & Professions WALLS &MODIFICATION 2 EXISTING CHAMBERS & Code and that my license is in full force and effect.ADDITION OF 8 NEW CHAMBERS. ERS. M E P & FIRE, 1 hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $500000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 31602106.FLRI Occupancy Type: APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this perm' Additio ly, the plicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non- po' s ce regul ons per a Cupertino Municipal Code, Section 9.18. Issued by: Date: Signature Date ❑ OWNER -BUILDER DECLARATION RE -ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material berg installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for 1, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: Date: 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1 hereby affirm under penalty of perjury one of the following three declarations: [ have and will maintain a Certificate of Consent to self -insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air permit is issued. contaminants as dethe Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued, I shall maintain mplianche upertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's afety Coon 25505, 25533, and 534. H7eo]authorizeJdnt: Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must O forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION ONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I he by affirm that th a is a construction lending agency for the performance of work's correct. I agree to comply with al I city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional WE��CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION I ADDRESS: 2 infinite loop 1st floor DATE: 07/15/2011 REVIEWED BY: APN: BP#: "VALUATION: 1$500,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 1 B TI PERMIT TYPE: WORK comet add new 8 chambers with structural. �t.i. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) I-A,I-B 2,750 $3,212.14 IBTIPLNCK $3,353.79 IBTHNSP TOTALS: 2,750 $3,212.14 : ? f''. $3•,353.79 NOTE: These fees are based on the nrelindnary information available and are only an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1,/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,212.14 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: G Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,353.79 Suppl. Insp. Fee-.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes (E) No $0.00 d 0 Work Without Permit? © Yes 0 No $0.00 .Planning Fee: $0.00 Select a Non -Residential Building or Structure Q i Strong; Motion Fee: IBSEISMICO $105.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $20.00 SI3•i$T .. l Q� ... 8 89 3 $ 0 9 $ 0.00 6 690.93 $ , Revised: 07/04/2011